NPI | 1104952076 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WI 50959-020) |
Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: WI 50959) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2021-11-07 |